• Title/Summary/Keyword: Uterine cervix

Search Result 243, Processing Time 0.025 seconds

Pre-radiotherapy and Post-radiotherapy Serial Serum Squamous Cell Carcinoma Antigen (SCC) and Carcinoembryonic Antigen (CEA) in the Monitoring of Squamous Cell Carcinoma of Uterine Cervix (자궁경부암 방사선치료시 Squamous Cell Carcinoma Antigen(SCC) 고k Carcinoembryonic Antigen(CEA) 의 종양표지자로서의 의의)

  • Yun, Hyong-Geun;Park, Choong-Hak
    • Radiation Oncology Journal
    • /
    • v.17 no.1
    • /
    • pp.30-35
    • /
    • 1999
  • Purpose : To evaluate the significance of squamous cell carcinoma antigen (SCC) and carcinoembryonic antigen (CEA) as tumor markers in uterine cervix carcinoma. Materials and Methods : In 22 patients with histologically proven primary squamous cell carcinoma of uterine cervix, tumor volume was checked either by using MRI (in 20 patients) or ultrasound (in 2 patients). Pre-treatment serum SCC levels were checked in 22 patients and CEA levels in 21 patients. After curative radiotherapy, post-treatment SCC and CEA were checked regularly. Results : SCC was raised In 68.2$\%$ and CEA was raised in 19.0$\%$ before treatment. The coefficient of correlation between tumor volume and pre-reatment SCC was 0.59382 when one extremely deviated case was excluded. And there was no correlation between tumor volume and CEA. After the treatment, SCC was raised En 9.1$\%$ and CEA was raised in 4.8$\%$. In further follow up measurement, raise of SCC was associated with clinical relapse or persistence of disease. The specificity of raised SCC level in association with recurrent or persistent disease was 93.8$\%$ . The sensitivity in association with recurrent or persistent disease was 100$\%$. The positive predictive values was 85.7$\%$. The median lead time for recurrence was 1.2 months. Conclusions: Both SCC and CEA were good tumor markers for monitoring treatment effect in patients with raised pre-treatment levels. But the sensitivity of pretreatment CEA was low, while that of pretreatment SCC was high. And there was no additional gain by adding CEA measurements to SCC measurements.

  • PDF

Long Term Follow Up Results of Serum Squamous Cell Carcinoma Antigen Level in Uterine Cervix Cancer Treated by Radiotherapy (자궁경부암 방사선치료 후 혈중 Squamous Cell Carcinoma 항원치의 장기추적 결과)

  • Yun, Hyong-Geun
    • Radiation Oncology Journal
    • /
    • v.21 no.4
    • /
    • pp.283-290
    • /
    • 2003
  • Purpose: To evaluate the long term significance of the squamous cell carcinoma (SCC) antigen (Ag) as a tumor marker in uterine cervix carcinoma. Materials and Methods: The SCC antigen levels of pre-radiotherapy and serial post-radiotherapy serum were analyzed in 48 patients who received radiotherapy with histologically proven primary SCC of the uterine cervix. Results: Pre-radiotherapy SCC Ag level was high ($\geq$2 ng/ml) at 79.2$\%$. After the treatment, the SCC Ag level was significantly decreased. The SCC Ag level measured at about 3 months after radiotherapy was high at 23.0$\%$. In further follow up measurements, a rise of the SCC Ag to a high level was well associated with clinical relapse. The specificity of the elevated SCC Ag level in association with recurrent or persistent disease was 100$\%$, and the sensitivity was 85.7$\%$. In 3 of 4 lung metastasis cases, lung lesions were detected in chest PA before elevation of the SCC Ag level. The median lead time of the high SCC Ag level to clinical recurrence was 4 months. Conclusion: SCC Ag was a good tumor marker for monitoring treatment effect in patients with increased pre-treatment levels except in case of early lung metastasis. Elevation of the SCC Ag level after radiotherapy accurately predicted the treatment failure with lead time of 4 months. But, in early lung metastasis cases, the SCC level may be normal temporarily. Thus, chest PA should be checked to evaluate the presence of lung metastasis.

Accelerated Hyperfractionated Radiotherapy for Locally Advanced Uterine Cervix Cancers (국소진행된 자궁경부암에서의 가속과분할 방사선치료)

  • Seo, Young-Seok;Cho, Chul-Koo;Yoo, Seong-Yul;Kim, Mi-Sook;Yang, Kang-Mo;Yoo, Hyung-Jun;Choi, Chul-Won;Lee, Kyung-Hee;Lee, Eui-Don;Rhu, Sang-Young;Choi, Suck-Chul;Kim, Moon-Hong;Kim, Beob-Jong
    • Radiation Oncology Journal
    • /
    • v.26 no.1
    • /
    • pp.24-34
    • /
    • 2008
  • Purpose: To assess the efficacy of the use of accelerated hyperfractionated radiotherapy(AHRT) for locally advanced uterine cervix cancers. Materials and Methods: Between May 2000 and September 2002, 179 patients were identified with FIGO stage IIB, IIIB, and IVA cancers. Of the 179 patients, 45 patients were treated with AHRT(AHRT group) and 134 patients were treated with conventional radiotherapy(CRT group), respectively. Patients undergoing the AHRT regimen received a dose of 30 Gy in 20 fractions(1.5 $Gy{\times}2$ fractions/day) to the whole pelvis. Subsequently, with a midline block, we administered a parametrial boost with a dose of 20 Gy using 2 Gy fractions. Patients also received two courses of low-dose-rate brachytherapy, up to a total dose of 85{\sim}90 Gy to point A. In the CRT group of patients, the total dose to point A was $85{\sim}90$ Gy. The overall treatment duration was a median of 37 and 66 days for patients that received AHRT and CRT, respectively. Statistical analysis was calculated by use of the Kaplan-Meier method, the log-rank test, and Chi-squared test. Results: For patients that received cisplatin-based concurrent chemotherapy and radiotherapy, the local control rate at 5 years was 100% and 79.2% for the AHRT and CRT group of patients, respectively(p=0.028). The 5-year survival rate for patients with a stage IIB bulky tumor was 82.6% and 62.1% for the AHRT group and CRT group, respectively(p=0.040). There was no statistically significant difference for severe late toxicity between the two groups(p=0.561). Conclusion: In this study, we observed that treatment with AHRT with concurrent chemotherapy allows a significant advantage of local control and survival for locally advanced uterine cervix cancers.

Measurement of Rectal Rodiation dose in the Patients with Uterine Cervix fencer using In Vivo Dosimetry(Diode Detector) (자궁경부암 환자에서 In vivo dosimetry(Diode detector)를 이용할 직장선량의 측정)

  • Kim, Sung-Kee;Kim, Wan-Sun
    • The Journal of Korean Society for Radiation Therapy
    • /
    • v.16 no.1
    • /
    • pp.29-37
    • /
    • 2004
  • Purpose : A rectum and a bladder should be carefully considered in order to decrease side effects when HDR patient of uterine cervix cancer. Generally speaking, the value of dosimeter at a rectum and a bladder only depends on the value of a planning equipment, while some analyses of the value of dosimetry at rectum with TLD has been reported Or the contrary, it is hardly to find a report with in vivo dosimetry(diode detector). On this thesis, we would like to suggest the following. When a patient of uterine cervix cancer is in therapy, it is helpful to put a diode detector inside of a rectum in order to measure the rectal dose Based upon the result of the dosimetry, the result can be used as basic data at decreasing side effects. Materials and Methods : Six patients of uterine cervix cancer(four with tandem and ovoid, one with cylinder, and the other one with tandem and cylinder) who had been irradiated with HDR. Ir-192 totally 28 times from February 2003 to June 2003. We irradiated twice in the same distant spots with anterior film and lateral film whenever we measured with a diode detector. Then we did planning and compared each film. Results : The result of the measurement 4 patients with a diode detector is the following. The average and deviation from 3 patients with tandem and ovoid were $274.1{\pm}13.4cGy$, from 1 patient with tandem and ovoid were $126.1{\pm}7.2cGy$, from 1 patient with cylinder were $99.7{\pm}7.1cGy$, and from 1 patient with tandem and cylinder were $77.7{\pm}11.5cGy$. Conclusion : It is difficult to predict how the side effect of a rectum since the result of measurement with a diode detector depends on the state of a rectum. According to the result of the study, it is effective to use a TLD or an in vivo dosimetry and measure a rectum in order to consider the side effect. It is very necessary to decrease the amount of irradiation by controlling properly the duration of the irradiation and gauze packing, and by using shield equipments especially when side effects can be expected.

  • PDF

Ultrastructural Effects of Irradiation on Squamous Cell Carcinoma of the Uterine Cervix (자궁경부의 편평상피암의 방사선치료에 수반되는 초미형태학적 변화)

  • Kim Jin Hee;Kim Ok Bae;Choi Tae Jin;Lee Sang Sook;Park Kwan Kyu;Kwon Kun Young;Suh Young Wook;Lee Tae Sung;Lee Tak;Cha Soon Do
    • Radiation Oncology Journal
    • /
    • v.9 no.2
    • /
    • pp.303-310
    • /
    • 1991
  • Nineteen patients with previously untreated invasive squamous cell carcinoma of the uterine cervix were treated by irradiation alone at the Keimyung University Hospital from January, 1990 to July, 1991. The serial samplings of the tissue taken before and during radiation of the uterine cervix were studied by light and electron microscopic examination. Radiation-induced cellular changes, particularly nuclear degeneration was pronounced. The tumor invasion pattern remained unchanged but the number of mitosis and tumor cells decreased, The number of infiltrating inflammatory cells, multinucleated giant cells and karyolytic cells were increased with radiation. Fibrosis was also increased. Electron microscopically, the amount of tonofilament in the tissue samplings was increased in the postirradiated state, but the desmosomes were decreased in numbers. Fibroblasts began to appear after an irradiation dose of 2700 cGy. After an irradiation dose of 3000 cGy or more, tumor cells were nearly completely degenerated and displaced with mature fibrotic tissue. There was an increase of activated fibroblasts and collagen fibers but a decrease of inflammatory cells in the interstitial tissue. Swelling of the mitochondria and endoplasmic reticulum, loss of intercellular bridges and an increased number of secondary lysosomes were also found with radiation.

  • PDF

Results of Radiation Therapy and Extrafascial Hysterectomy in Bulky Stage IB, IIA-B Carcinoma of the Uterine Cervix (종괴가 큰 병기 IB, IIA-B 자궁경부암에서 방사선치료와 Extrafascial Hysterectomy의 결과)

  • Kim Jin Hee;Lee Ho Jun;Choi Tae Jin;Do Cha Soon;Lee Tae Sung;Kim Ok Bae
    • Radiation Oncology Journal
    • /
    • v.17 no.1
    • /
    • pp.23-29
    • /
    • 1999
  • Purpose : To evaluate the efficacy of radiation therapy and extrafascial hysterectomy in bulky stage IB, IIA-B uterine cervix cancers. Methods and Materials : Twenty four patients with bulky stage IB and IIA-B carcinoma of the uterine cervix were treated with extrafascial hysterectomy following radiation therapy due to doubts of residual disease at Department of therapeutic radiology, Keimyung University, Dongsan Hospital, from April 1986 to December 1997 According to FIGO staging system, there were 7 patients with stage IB, 9 patients with IIA and 8 patients with IIB stage whose median age was 45. Pathologic distribution showed 16 patients with squamous cell carcinoma and 8 patients with adenocarcinoma. Seven patients had tumors that are less than 5cm in size and 17 patients had tumors with larger than 5cm. The mean interval between radiation therapy and extrafascial hysterectomy was 57 days. The radiation therapy consisted of external irradition to the whole pelvis (180 cGy/fraction, mean 4100 cGy) and parametrial boost (for a mean total dose of 5000 cGy) with midline shield (4H 10 cm), followed by intracavitary irradiation up to 7500 cGy to point A (maximum 8500 cGy). The maximum follow up duration was 107 months and mean follow up duration was 42 months. Results :Ten out of 24 patients (41.7%) had residual disease found at the time of extrafascial hysterectomies. Five year overall survival rate (5Y OSR) and five year disease free survival rate (5Y DFSR) were 63.6% and 62.5% respectively. Five year overall survival rate for stage IB and IIA was 71.4% and 50% for stage IIB. There was a significant difference in 5Y OSR and 5Y DFSR between patients with and those without residual disease (negative vs positive, 83.3% vs. 40% (P=0.01), 83.3% vs 36% (P=0.01) respectively). There was a notable tendency of better survival with adenocarcinoma than with squamous cell carcinoma (adenocarcinoma vs squamous cell carcinoma, 85.7% vs. 53.3% (P=0.1), 85.7% vs. 50.9% (P=0.1) of 5Y OSR and 5Y DFS respectivey). Total dose to A point did not make a significant difference in survival rate or the existence of residual lesion (< 7500 cGy, ${\geq}$ 7500 cOy). It was also noted that significantly more frequent local failures have occurred in patients with positive residual disease compared with negative residual disease (5/10 vs. 0/14, p=0.003), There was no death related to the treatment. Conclusion : There was no improvement of residual disease and to the overall survival rate in spite of increased total dose to point A. We conclude that there is a possible beneficial effect of radiation therapy followed by extrafaseial hysterectomy in survival for adenocarcinoma of bulky stage IB and IIA-B uterine cervix. We need to confirm this with longer follow up and with large number of patients.

  • PDF

Transcervical Embryo Recovery in Korean Black Goats: A Preliminary Experiment

  • Lee, Doo-Soo;Kim, Dong-Woo;Shin, Sang Tae
    • Journal of Embryo Transfer
    • /
    • v.30 no.3
    • /
    • pp.171-174
    • /
    • 2015
  • Four pluriparous Korean black goat does were superovulated with FSH and mated with fertile bucks. Anesthetized animals were placed in lateral recumbency, then size 8 Foley catheter was inserted into the uterus through the cervix under the vaginal speculum and the balloon was inflated to fix the catheter in the uterine body. The opposite end of the catheter was connected to a 3-way and a flushing medium was infused into the uterus. Modified Dubecco's PBS with 1% FBS was used as the flushing medium. Four goats were allocated in two groups depending on the type of medium infusion into uterus. Injection group; the flushing medium was injected into uterus and the infused medium was collected by to-and-fro method using a syringe. Gravity-flow group; the flushing medium was allowed to enter the uterus by gravity flow by lifting the medium bottle and drained out of the uterus into a collecting tube. All four goats had catheter inserted through the cervix and uteri flushed successfully. The volume (recovery rate) of recovered medium varied considerably from 87 ml/200 ml (43.5%) to 148 ml/160 ml (92.5%). Nine embryos/ova in total were recovered from Gravity-flow group goats. Although the embryo recovery rate was low, the possibility of a transcervical embryo recovery in Korean black goat had been proven in this preliminary experiment.

Analysis of Pretreatment Prognostic Factors in Locally Advanced Carcinoma of the Uterine Cervix (국소진행된 자궁경부암에 있어서의 예후인자 분석)

  • Oh, Do-Hoon;Ha, Sung-Whan;Lee, Moo-Song
    • Radiation Oncology Journal
    • /
    • v.10 no.1
    • /
    • pp.69-76
    • /
    • 1992
  • To identify pretreatment prognostic factors in locally advanced carcinoma of the uterine cervix, retrospective analysis was undertaken of 154 patients treated with curative radiation therapy at Seoul National University Hospital, from March 1979 through December 1986. According to FIGO classification, eight patients were stage IIIA, 134 were stage IIIB, and 12 were stage IVA. Five year locoregional control rate was $58\%$, $51\%$, and $27\%$ in stage IIIA, IIIB, and IVA, respectively. Five year disease free survival was $57\%$, $40\%$, and $25\%$ for each stage respectively. Five year overall survival was $67\%$, $51\%$, and $33\%$ in stage IIIA, IIIB, and IVA, respectively. In univariate analysis, fewer than or equal to four of pregnancies, initial hemoglobin of lower than $10\;g\%$, and pelvic sidewall invasion on CT were associated with poor locoregional control. Number of pregnancies, initial hemoglobin level, obstructive uropathy on intavenous pyelography (IVP), pelvic lymph node (LN) status on CT, and pelvic sidewall invasion on CT were significant factors in disease free survival. In terms of overall survival, pelvic sidewall invasion on CT and bladder invasion on CT were prognostically significant. In multivariate analysis, no factor was found to affect locoregional control and pelvic LN status was a sole significant factor affecting disease free survival. in terms of overall survival, the size.

  • PDF

Closed-Cervix Pyometra in Young Dogs: 2 Cases

  • Koo, Ok-Jae;Hong, So-Gun;Kang, Jung-Taek;Park, Jung-Eun;Kim, Min-Jung;Jang, Goo;Lee, Byeong-Chun
    • Journal of Embryo Transfer
    • /
    • v.26 no.4
    • /
    • pp.283-286
    • /
    • 2011
  • Canine pyometra generally occurs in intact female dogs of more than four years of age. However, in rarely cases, pyometra can occur in young bitches. In the present report, two cases of pyometra in thirteen and eighteen months of age were presented. In both cases, absent of vaginal discharge represented that both patients had closed-cervix pyometra and diagnosis was somewhat complicated. In complete blood count, elevated level of leukocyte with left shift was found in both cases. Serum chemistry analysis showed elevation of alkaline phosphatase in both cases. Additionally, mild elevation of aspartate transferase and total protein were also found in $2^{nd}$ case. Radiographic and ultrasonographic findings show the enlargement of uterus and accumulation of fluid contents inside the uterine lumen. Ovariohysterectomy followed by antibiotics and anti-inflammatory drugs for post-surgery medication was performed for treatment. After a week, both patients fully recovered. To reduce mortality of pyometra in young intact female dogs, radiography or ultrasonography should be indicated immediately in the bitches showing severe infectious inflammation.

Dose Distribution of Rectum in the treatment of Uterine Cervical Cancer using Remote Afterloading System (RALS시행시 선원의 거리 이동및 직장선량에 관한 계산치와 측정치의 비교연구)

  • 김성규;신세원;김명세
    • Progress in Medical Physics
    • /
    • v.5 no.1
    • /
    • pp.67-74
    • /
    • 1994
  • Dose distribution of point source represents an inverse square law as the distance, Difference of measurement value and calculation value according to moving distance of radiation source show very large error in dose calculation of Brachytherapy. Therefore, in RALS of high dose rate, dose calculation have an important effect in treatment of uterine cervix cancer and recurrent rate. In this paper, authors measured moving distance of radiation source carrying out RALS. And we measured Rectum dose compared with calculationdose.

  • PDF